Optimal usage guides for pharmacological treatment of sexually transmitted and blood-borne infections (STBBI)

2024-09-23 UPDATE OF THE OPTIMAL USAGE GUIDE – Confirmed Chlamydia trachomatis or Neisseria gonorrhoeae infection
The last update of the Institut national d’excellence en santé et en services sociaux’s optimal usage guide (OUG) on confirmed Chlamydia trachomatis or Neisseria gonorrhoeae infection and decision algorithm for the epidemiological treatment of asymptomatic partners was done in 2020. Since N. gonorrhoeae resistance to antibiotics continues to increase and changes have been made to certain recommendations in national and international guidelines, it was considered advisable to revise the contents of the optimal usage guide and decision algorithm in light of the available new data and guidelines.
 

2020-08-31 UPDATE OF THE OPTIMAL USAGE GUIDE on sexually transmitted and blood-borne infections – Uncomplicated Chlamydia trachomatis or Neisseria gonorrhoeae infection
This optimal usage guide concerns asymptomatic persons aged 14 years and older with a positive screening test result for infection by Chlamydia trachomatis or Neisseria gonorrhoeae, and asymptomatic persons aged 14 years and older identified as sexual partners of individuals presenting with infection by Chlamydia trachomatis or Neisseria gonorrhoeae.

2020-08-31 UPDATE OF THE OPTIMAL USAGE GUIDE on sexually transmitted and blood-borne infections – Syndromic approach
This optimal usage guide concerns individuals aged 14 years and older and deals exclusively with the syndromic approach, that is, managing clinical syndromes potentially associated with STBBIs before obtaining the laboratory test results.

UPDATE – In case of a shortage of cefixime (Suprax®)
Québec, May 26, 2014 - Following the manufacturer’s announcement of a possible shortage of cefixime (Suprax®), INESSS has recommended some adjustments to the use of two of its guides: (1) Pharmacological Treatment: Chlamydia Trachomatis Infection, Neisseria Gonorrhoeae Infection; and (2) Pharmacological Treatment: Mucopurulent Cervicitis, Pelvic Inflammatory Disease (PID), Urethritis, Epididymitis/Epididymo‑orchitis.

For more information, please see the full press release.

UPDATE - Syphilis serodiagnostic interpretation table
Québec, January 30, 2014 – INESSS has made changes to its guide concerning syphilis, specifically to the syphilis serodiagnostic interpretation table. These changes reflect the results of a quality assurance project that was conducted in partnership between the Comité sur les analyses de laboratoires en lien avec les ITSS (CALI) and the Laboratoire de santé publique du Québec (LSPQ) in 2012–2013. The project showed that a significant proportion (3.3%) of reactive EIA/CIA and reactive RPR serum samples were not confirmed by the LSPQ as cases of syphilis. Medical laboratories using EIA/CIA as a first test for detecting syphilis must now send the LSPQ all reactive EIA/CIA and reactive RPR serum samples whose titre is between 1:1 and 1:4 for treponemal confirmatory testing. This change may affect the clinical interpretation of certain profiles. Accordingly, it was imperative that the interpretation table be updated.

UPDATE - Treatment for Neisseria gonorrhoeae infections
Québec, October 31, 2013 – In August 2012, the Centers for Disease Control and Prevention (CDC) published an update to its Sexually Transmitted Diseases Treatment Guidelines, 2010. It no longer recommends the use of third-generation oral cephalosporins as a treatment for Neisseria gonorrhoeae infections. In addition, the July 2013 revised chapter on gonococcal infections of the Canadian Guidelines on Sexually Transmitted Infections makes distinctions about which antibiotics to use based on the patient’s sex and sexual behaviours. Recent epidemiological data from Quebec do not support these distinctions.

INESSS continues to recommend a single dose of cefixime 800 mg orally or a single dose of ceftriaxone 250 mg intramuscularly for the treatment of uncomplicated non-pharyngeal Neisseria gonorrhoeae infections (cervicitis, urethritis, anorectal infections). INESSS also continues to recommend a single dose of ceftriaxone 250 mg intramuscularly for the treatment of pharyngeal and complicated Neisseria gonorrhoeae infections. In all cases, combination treatment against Chlamydia trachomatis is recommended.

For more information on these recommendations and to learn about the experts who contributed to the update, please consult the PDF version of the full press release in the blue box. 

The Institut national d’excellence en santé et en services sociaux (INESSS) has developed a series of five clinical guides for the pharmacological treatment of sexually transmitted and blood-borne infections (STBBIs). The guides address the following conditions: 

• Chlamydia trachomatis infection and Neisseria gonorrhoeae infection;
• Genital herpes;
• Mucopurulent cervicitis, pelvic inflammatory disease, urethritis, epididymitis/epididymo-orchitis;
• Condylomas;
• Syphilis.

The guides are meant to provide various practitioners (general practitioners, specialists, pharmacists and nurses) with support for managing the pharmacological treatment of patients with an STBBI. These clinical tools have been adapted from the Canadian Guidelines on Sexually Transmitted Infections. In order to complete the adaptation and to disseminate the latest, most accurate information promoting the optimal use of drug products, INESSS worked closely with an expert committee on STBBIs, with support from the relevant professional bodies, associations and federations.